Advertisement

Systematic Reviews and Clinical Trials in Rehabilitation: Comprehensive Analyses of Publication Trends

  • Tiago S. Jesus
    Correspondence
    Corresponding author Tiago S. Jesus, PhD, Portuguese Ministry of Education, Aggregation of Schools of Escariz, 4540-320 Escariz, Portugal.
    Affiliations
    Portuguese Ministry of Education, Aggregation of Schools of Escariz, Escariz, Portugal
    Search for articles by this author

      Abstract

      Objective

      To analyze publication trends of clinical trials (CTs) and systematic reviews (SRs) in rehabilitation.

      Design

      PubMed searches were performed with appropriate combinations of Medical Subject Headings. All entries until December 2013, and their yearly distributions since 1981 (when the first rehabilitation SR was identified), were retrieved. After the initial data visualization, data analyses were narrowed to specific periods. Linear regression techniques analyzed the growth of publications and their relative percentages over time.

      Setting

      Not applicable.

      Participants

      Not applicable.

      Interventions

      Not applicable.

      Main Outcome Measures

      Not applicable.

      Results

      Although not observed for SRs, CTs have grown at a much higher rate in rehabilitation than in the broader health/medical field—more than twice the difference for both periods analyzed (1989–2001, 2001–2013). Rehabilitation journals published about 20% or less of the rehabilitation SRs and CTs, and no significant increases were observed over time (P>.05; 2001–2013). Neurologic conditions, particularly cerebrovascular, were the most addressed by rehabilitation SRs and CTs, while differences between neurologic and other groups of conditions typically widened over time (eg, more than doubled between neurologic and musculoskeletal conditions in 15y).

      Conclusions

      While publications of CTs are increasing at a much higher rate within rehabilitation than within broader health care, further research is warranted to explain why this trend is not being followed by SRs, particularly those with meta-analysis. Similarly, research might determine whether the (growing) differences in the publications of rehabilitation SRs and CTs across groups of conditions are justified by clinical or population need.

      Keywords

      List of abbreviations:

      CT (clinical trial), MeSH (Medical Subject Headings), RCT (randomized controlled trial), SR (systematic review), SR&MA (systematic review and meta-analysis)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bastian H.
        • Glasziou P.
        • Chalmers I.
        Seventy-five trials and eleven systematic reviews a day: how will we ever keep up?.
        PLoS Med. 2010; 7: e1000326
        • Mimouni M.
        • Cismariu-Potash K.
        • Ratmansky M.
        • Shaklai S.
        • Amir H.
        • Mimouni-Bloch A.
        Trends in physical medicine and rehabilitation publications over the past 16 years.
        Arch Phys Med Rehabil. 2016; 97: 1030-1033
        • Dijkers M.P.
        • Bushnik T.
        • Heinemann A.W.
        • et al.
        Systematic reviews for informing rehabilitation practice: an introduction.
        Arch Phys Med Rehabil. 2012; 93: 912-918
        • Hoffmann T.
        • Erueti C.
        • Thorning S.
        • Glasziou P.
        The scatter of research: cross sectional comparison of randomised trials and systematic reviews across specialties.
        BMJ. 2012; 344: e3223
        • Coronado R.A.
        • Riddle D.L.
        • Wurtzel W.A.
        • George S.Z.
        Bibliometric analysis of articles published from 1980 to 2009 in Physical Therapy, journal of the American Physical Therapy Association.
        Phys Ther. 2011; 91: 642-655
        • Simon C.B.
        • Coronado R.A.
        • Wurtzel W.A.
        • Riddle D.L.
        • George S.Z.
        Content and bibliometric analyses of the Journal of Manual & Manipulative Therapy.
        J Man Manip Ther. 2014; 22: 181-190
        • Coronado R.A.
        • Wurtzel W.A.
        • Simon C.B.
        • Riddle D.L.
        • George S.Z.
        Content and bibliometric analysis of articles published in the Journal of Orthopaedic & Sports Physical Therapy.
        J Orthop Sports Phys Ther. 2011; 41: 920-931
        • Grimby G.
        Bibliometric indicators and international publishing in physical and rehabilitation medicine.
        J Rehabil Med. 2011; 43: 469-470
        • Kocak F.U.
        • Unver B.
        • Karatosun V.
        Level of evidence in four selected rehabilitation journals.
        Arch Phys Med Rehabil. 2011; 92: 299-303
        • Paci M.
        • Briganti G.
        • Lombardi B.
        Levels of evidence of articles published in Physical and Rehabilitation Medicine journals.
        J Rehabil Med. 2011; 43: 264-267
        • Miller P.A.
        • McKibbon K.A.
        • Haynes R.B.
        A quantitative analysis of research publications in physical therapy journals.
        Phys Ther. 2003; 83: 123-131
        • Paci M.
        • Cigna C.
        • Baccini M.
        • Rinaldi L.A.
        Types of article published in physiotherapy journals: a quantitative analysis.
        Physiother Res Int. 2009; 14: 203-212
        • Saragiotto B.T.
        • Costa L.C.
        • Oliveira R.F.
        • Lopes A.D.
        • Moseley A.M.
        • Costa L.O.
        Description of research design of articles published in four Brazilian physical therapy journals.
        Braz J Phys Ther. 2014; 18: 56-62
        • Ugolini D.
        • Neri M.
        • Cesario A.
        • et al.
        Scientific production in cancer rehabilitation grows higher: a bibliometric analysis.
        Support Care Cancer. 2012; 20: 1629-1638
        • Ugolini D.
        • Neri M.
        • Cesario A.
        • et al.
        Bibliometric analysis of literature in cerebrovascular and cardiovascular diseases rehabilitation: growing numbers, reducing impact factor.
        Arch Phys Med Rehabil. 2013; 94: 324-331
        • Feng X.
        • Liu C.
        • Guo Q.
        • et al.
        Research progress in rehabilitation treatment of stroke patients: a bibliometric analysis.
        Neural Regen Res. 2013; 8: 1423-1430
        • DeJong G.
        • Horn S.D.
        • Conroy B.
        • Nichols D.
        • Healton E.B.
        Opening the black box of post-stroke rehabilitation: stroke rehabilitation patients, processes, and outcomes.
        Arch Phys Med Rehabil. 2005; 86: S1-S7
        • Vos T.
        • Flaxman A.D.
        • Naghavi M.
        • et al.
        Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.
        Lancet. 2012; 380: 2163-2196
        • Murray C.J.
        • Vos T.
        • Lozano R.
        • et al.
        Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.
        Lancet. 2012; 380: 2197-2223
        • World Health Organization
        World report on disability.
        WHO, Geneve2011
        • Negrini S.
        • Padua L.
        • Kiekens C.
        • Michail X.
        • Boldrini P.
        Current research funding methods dumb down health care and rehabilitation for disabled people and aging population: a call for a change.
        Eur J Phys Rehabil Med. 2014; 50: 601-608
        • Brown P.A.
        • Harniss M.K.
        • Schomer K.G.
        • Feinberg M.
        • Cullen N.K.
        • Johnson K.L.
        Conducting systematic evidence reviews: core concepts and lessons learned.
        Arch Phys Med Rehabil. 2012; 93: S177-S184
        • Liu D.
        • Liu R.
        • Xie M.
        Multivariate meta-analysis of heterogeneous studies using only summary statistics: efficiency and robustness.
        J Am Stat Assoc. 2015; 110: 326-340
        • Zeng D.
        • Lin D.Y.
        On random-effects meta-analysis.
        Biometrika. 2015; 102: 281-294
        • Gunn H.
        • Markevics S.
        • Haas B.
        • Marsden J.
        • Freeman J.
        Systematic review: the effectiveness of interventions to reduce falls and improve balance in adults with multiple sclerosis.
        Arch Phys Med Rehabil. 2015; 96: 1898-1912
        • Kamper S.J.
        • Apeldoorn A.T.
        • Chiarotto A.
        • et al.
        Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis.
        BMJ. 2015; 350: h444
        • Uthman O.A.
        • van der Windt D.A.
        • Jordan J.L.
        • et al.
        Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis.
        BMJ. 2013; 347: f5555
        • Chang K.V.
        • Chen S.Y.
        • Chen W.S.
        • Tu Y.K.
        • Chien K.L.
        Comparative effectiveness of focused shock wave therapy of different intensity levels and radial shock wave therapy for treating plantar fasciitis: a systematic review and network meta-analysis.
        Arch Phys Med Rehabil. 2012; 93: 1259-1268
        • Gianola S.
        • Gasparini M.
        • Agostini M.
        • et al.
        Survey of the reporting characteristics of systematic reviews in rehabilitation.
        Phys Ther. 2013; 93: 1456-1466
        • Negrini S.
        • Kiekens C.
        • Meerpohl J.J.
        • et al.
        Contributing to the growth of physical and rehabilitation medicine (PRM): call for a Cochrane Field in PRM.
        Eur J Phys Rehabil Med. 2015; 51: 239-243
        • Kiekens C.
        • Negrini S.
        • Thomson D.
        • Frontera W.
        Cochrane physical and rehabilitation medicine: current state of development and next steps.
        Am J Phys Med Rehabil. 2016; 95: 235-238
        • Delitto A.
        Pragmatic clinical trials: implementation opportunity, or just another fad?.
        Phys Ther. 2016; 96: 137-138
        • Horn S.D.
        • Corrigan J.D.
        • Bogner J.
        • et al.
        Traumatic brain injury-practice based evidence study: design and patients, centers, treatments, and outcomes.
        Arch Phys Med Rehabil. 2015; 96: S178-S196
        • Seel R.T.
        • Dijkers M.P.
        • Johnston M.V.
        Developing and using evidence to improve rehabilitation practice.
        Arch Phys Med Rehabil. 2012; 93: S97-S100
        • Horn S.D.
        • DeJong G.
        • Deutscher D.
        Practice-based evidence research in rehabilitation: an alternative to randomized controlled trials and traditional observational studies.
        Arch Phys Med Rehabil. 2012; 93: S127-S137
        • Hart T.
        • Bagiella E.
        Design and implementation of clinical trials in rehabilitation research.
        Arch Phys Med Rehabil. 2012; 93: S117-S126
        • Gordon W.A.
        Clinical trials in rehabilitation research: balancing rigor and relevance.
        Arch Phys Med Rehabil. 2009; 90: S1-S2
        • Johnston M.
        • Vanderheiden G.
        • Farkas M.
        • Rogers E.
        • Summers J.
        • Westbrook J.
        The challenge of evidence in disability and rehabilitation research and practice: a position paper. NCDDR Task Force on Standards of Evidence and Methods.
        SEDL, Austin2009
        • Johnston M.V.
        • Dijkers M.P.
        Toward improved evidence standards and methods for rehabilitation: recommendations and challenges.
        Arch Phys Med Rehabil. 2012; 93: S185-S199
        • Heinemann A.W.
        State-of-the-science on postacute rehabilitation: setting a research agenda and developing an evidence base for practice and public policy. An introduction.
        Arch Phys Med Rehabil. 2007; 88: 1478-1481
        • Velozo C.A.
        • Seel R.T.
        • Magasi S.
        • Heinemann A.W.
        • Romero S.
        Improving measurement methods in rehabilitation: core concepts and recommendations for scale development.
        Arch Phys Med Rehabil. 2012; 93: S154-S163
        • Özçakar L.
        • Franchignoni F.
        • Kara M.
        • Muñoz Lasa S.
        Choosing a scholarly journal during manuscript submission: the way how it rings true for physiatrists.
        Eur J Phys Rehabil Med. 2012; 48: 643-647
        • Buchanan H.
        • Siegfried N.
        • Jelsma J.
        Survey instruments for knowledge, skills, attitudes and behaviour related to evidence-based practice in occupational therapy: a systematic review.
        Occup Ther Int. 2016; 23: 59-90
        • Sadeghi-Bazargani H.
        • Tabrizi J.S.
        • Azami-Aghdash S.
        Barriers to evidence-based medicine: a systematic review.
        J Eval Clin Pract. 2014; 20: 793-802
        • Michaleff Z.A.
        • Costa L.O.
        • Moseley A.M.
        • et al.
        CENTRAL, PEDro, PubMed, and EMBASE are the most comprehensive databases indexing randomized controlled trials of physical therapy interventions.
        Phys Ther. 2011; 91: 90-97
        • Moore J.L.
        • Raad J.
        • Ehrlich-Jones L.
        • Heinemann A.W.
        Development and use of a knowledge translation tool: the Rehabilitation Measures Database.
        Arch Phys Med Rehabil. 2014; 95: 197-202
        • Levac D.
        • Glegg S.M.
        • Camden C.
        • Rivard L.M.
        • Missiuna C.
        Best practice recommendations for the development, implementation, and evaluation of online knowledge translation resources in rehabilitation.
        Phys Ther. 2015; 95: 648-662
        • McCluskey A.
        • Bennett S.
        • Hoffmann T.
        • Tooth L.
        OTseeker helps library and allied health professionals to find quality evidence efficiently.
        Health Info Libr J. 2010; 27: 106-113
        • Jones C.A.
        • Roop S.C.
        • Pohar S.L.
        • Albrecht L.
        • Scott S.D.
        Translating knowledge in rehabilitation: systematic review.
        Phys Ther. 2015; 95: 663-677
        • Ma V.Y.
        • Chan L.
        • Carruthers K.J.
        Incidence, prevalence, costs, and impact on disability of common conditions requiring rehabilitation in the United States: stroke, spinal cord injury, traumatic brain injury, multiple sclerosis, osteoarthritis, rheumatoid arthritis, limb loss, and back pain.
        Arch Phys Med Rehabil. 2014; 95: 986-995
      1. US National Library of Medicine. MEDLINE data changes–2016. NLM technical bulletin. Available at: https://www.nlm.nih.gov/pubs/techbull/nd15/nd15_medline_data_changes_2016.html#pub_types1. Accessed February 24, 2016.

        • Wilczynski N.L.
        • Haynes R.B.
        Consistency and accuracy of indexing systematic review articles and meta-analyses in medline.
        Health Info Libr J. 2009; 26: 203-210
        • Boluyt N.
        • Tjosvold L.
        • Lefebvre C.
        • Klassen T.P.
        • Offringa M.
        Usefulness of systematic review search strategies in finding child health systematic reviews in MEDLINE.
        Arch Pediatr Adolesc Med. 2008; 162: 111-116
        • Moher D.
        • Tetzlaff J.
        • Tricco A.C.
        • Sampson M.
        • Altman D.G.
        Epidemiology and reporting characteristics of systematic reviews.
        PLoS Med. 2007; 4: e78
        • Wilczynski N.L.
        • Lokker C.
        • McKibbon K.A.
        • Hobson N.
        • Haynes R.B.
        Limits of search filter development.
        J Med Libr Assoc. 2016; 104: 42-46
        • Jesus T.S.
        • Hoenig H.
        Postacute rehabilitation quality of care: toward a shared conceptual framework.
        Arch Phys Med Rehabil. 2015; 96: 960-969
        • Snell K.
        • Hassan A.
        • Sutherland L.
        • et al.
        Types and quality of physical therapy research publications: has there been a change in the past decade?.
        Physiother Can. 2014; 66: 382-391
        • Chevan J.
        • Haskvitz E.M.
        Reported characteristics of participants in physical therapy-related clinical trials.
        Phys Ther. 2015; 95: 884-890
        • Kerry R.
        • Madouasse A.
        • Arthur A.
        • Mumford S.D.
        Analysis of scientific truth status in controlled rehabilitation trials.
        J Eval Clin Pract. 2013; 19: 617-625